Techniques for handling resistances in group psychotherapy with severely disturbed patients

There has been an increased interest in recent years in the treatment of those with severe psychopathology through application of object relations theory and modern ego psychology. Yet, for the past 20 years, such patients have been treated in day hospitals where rehabilitation and socialization concepts have been employed. This paper integrates some of the advances in psychoanalytic theory with more established methods of milieu therapy. In the patients studied, the therapists noted the presence of severe envy, dependency, passivity and with-holding, an intolerance for aggression along with an intransigent, paranoid-schizoid position. The techniques described here worked through the effects of these resistances so that the patients could use the psychotherapy group, and the entire milieu, more constructively than they did before.Ruthe Feilbert-Willis, C.S.W. was formerly Senior Social Worker in the Adolescent and Adult Day Hospital at The New York Hospital-Cornell Medical Center, in White Plains, New York.He was a psychiatric resident at The New York Hospital-Cornell Medical Center, in White Plains, New York, during the time the clinical work of this paper was undertaken.